Short Leg and Hip Pain

Today I received an email from a reader of this blog. I get so many questions from people (I moderate several forums and blogs) that I’ve asked my webmaster to fix it so blog questions will either go straight to the free forum or the person can order a telephone or email consultation. However I think this message is important and I want to answer it here so everyone can benefit from this problem. Naturally I won’t be using the readers name.

My left leg constantly gets hiked up and appears shorter than my right. I get pain in my groin and pubic bone area. At one point my PT said he had never seen such a difference in height between the left and right side of the pubic symphisis. Can you explain why my LEFT side constantly pulls my hip up? He can fix it but it doesn’t last forever… THANKS
Your left leg isn’t shorter than your right leg unless the doctors have done an x-ray and then measured both of your legs to see if there is a discrepency in the length of your two legs. However, if your left iliopsoas muscle is in spasm it will pull your left leg up so much that it “appears” shorter.

I know that I’ve given the link to the thread on my Muscle and Joint Pain forum, but this time I’m going to give the entire response because it’s really important and I want to have it in as many places as possible so more people will learn why muscles will rotate your pelvis forward and down, causing the symptoms mentioned in the message above, as well as a long list of other problems.

This is the explanation of the reason for doing the Julstro Protocol and is copied from the Muscle and Joint Pain Forum:

Low back, hip (TFL), groin, tight hamstrings, knee pain, chronic calf spasms, as well as tight lateral rotators and sciatica, are all frequently caused by a muscle most people don’t know they have, it’s called the iliopsoas. The iliopsoas is actually a two part muscle, it is the psoas which originates on your anterior lumbar vertebrae, passes along the inside of your pelvis (hip bones), and the iliacus which originates along the inside curve of your pelvis, then merges with the psoas and then the iliopsoas inserts into the top/inside of your thigh bone

When the iliopsoas contracts you either bend over, lift your leg to take a step, or you sit down. The muscle is actually contracted about 95% of a person’s life because it is even contracted when we sleep (unless you keep your trunk and legs perfectly straight while you are sleeping). The muscle shortens and this causes your pelvis to rotate forward and down. While this is happening, your quadriceps (thigh muscle) needs to shorten or it is too long to straighten your leg out from the bent position. The now-shorter quadriceps will continue the tug on the front of your pelvis, and you now have two muscles pulling your pelvis down in the front.

As your anterior pelvis is moving down, your pubic bone is moving backward (putting a lot of pressure on the groin muscles) and the posterior pelvis is moving UP. At the top of your posterior pelvis is a muscle called quadratus lumborum (QL for short). The QL originates on your 12th thoracic rib and runs along your lumbar vertebrae before inserting into the top of your posterior pelvis. When the QL contracts normally you lift your pelvis up in the back so your leg can move at the hip joint. However, when the pelvis has moved the bone up in the back your QL had to contract or it was too long to do the job. Then, when you try to sit down the QL is now too short to stretch and you feel pain at your lumbar spine and also along the top of your pelvis. You now have the iliopsoas pulling down on your low back when you stand, and your QL pulling down on your low back when you sit – you can’t find anyplace that doesn’t hurt.

As the pelvis is rotating, your TFL, gluteus minimus and medius, and the six deep lateral rotator muscles that move your leg so it turns out from your body, are all getting a torque in the fibers, and they are overstretching This will cause them to be very tight, although the tightness isn’t coming from them shortening due to spasms, but instead from the lengthening due to the pull placed on them as your pelvis rotates. As this is happening they do go into a spasm, so now you are dealing with a muscle that has spasms and is also being overstretched.

Another thing that is happening when your iliopsoas is contracted is the pelvis rotation puts pressure on your hamstrings (probably already tight because they are responsible for bending your leg and are also repetitively strained) and it also puts pressure onto your sciatic nerve and low back.

The hamstrings are most likely already tight and in spasm because they are responsible for bending your leg, and are also repetitively strained. The tight hamstrings will cause pain at the back of your knee and at the very top of your leg, where they originate on your posterior pelvis. You may have problems putting your legs down flat on the floor and you think you need to stretch your hamstrings, it is very important that you do not stretch them until after you have released all of the other muscles first so your pelvis has moved back where it belongs and it is not longer being overstretched. To stretch your hamstrings prior to releasing the pelvis rotation will further overstretch the fibers, and you could potentially tear the hamstrings or even cause them to sever from the bone.

Putting direct pressure on the various muscles that rotate your pelvis will release the tension on the pelvis, and therefore release the tension on the muscles and insertion points at the different joints.

If you already have my book, Treat Yourself to Pain Free Living, here is the Julstro Protocol. I strongly suggest that you do the treatments in the order give. The page numbers are for Version Two of the book. Thank you very much to Dan, a forum member who took the time to update the page numbers for Version Two.

Julstro Protocol for Low Back/Groin/Sciatica/Hip/Knee Pain

1. quadriceps (just the treatment, not the stretch yet) (T-153)
2. tensor fascia lata and gluteus minimus (hip) (T & S 146-149)
3. piriformis (butt – actually, all the muscles that originate on your sacrum, but as you treat this one you’ll be getting the others) both the treatment and the stretch. (T-142-143) (S-144-145)
4. erector spinae (long muscle of your back, be sure you don’t press on your spine), just the treatment for now. (T-120-121)
5. quadratus lumborum (low back – you’ll treat this at the end of the erector spinae treatment) (T-134) (S-135)
6. go along the top of your posterior pelvis to treat the insertion of the quadratus lumborum and the gluteus maximus muscles (Chart10)
7. iliopsoas stretch (be sure your knee is pointing toward the ground and that the bent knee is further back than the standing leg) (S-136-138)
8. treatment and stretch for the erector spinae, which will also treat the quadratus lumborum (T-120-121) (S-116-118)
9. quadratus lumborum stretch (T-134) (S-135)
10. quadriceps again, this time do the treatment and the stretch (T-153) (S-154)
11. hamstring treatment and stretch (T-156) (S-157-158).
12. iliopsoas stretch again (S-136-138)
13. thoroughly work out your calf and lower leg muscles, doing all the various treatments shown in the book. (T- 170-174)(S-175).

3 Responses to Short Leg and Hip Pain

David Gilling:January 28, 2017 at 1:35 pm

my son has been suffering from tight hamstrings from the age of about 12. He played on regardless as he was a exceptional player and the team needed him. He was told by a physio to do stretching for his ham strings but it has persisted. We have noticed that one leg is shorter. He now plays football and does boxing and is very fit. But he is suffering very tight and sore hamstrings. The pain is lower on left and high near to the Glutis Maxim on the right leg.

Hi David. Before talking about muscles I am curious if you ever had both of his legs x-rayed and then measured to see if the bones were actually a different length? If not, it might be something good to do so you know where your son is anatomically before addressing the muscular causes of short leg. If both bones are the same length, and the odds are good that they probably are, then the only way for a leg to be short is for the muscles to be pulling up on the bones, making it appear short. With his hamstrings being taut (more likely they are both in spasm and are overstretched at the same time), and having short leg syndrome, I would say the first muscles that need to be treated are his psoas and iliacus. The muscles that commonly cause short leg are the gluteus maximus, tensor fascia lata, the psoas, and the iliacus. The lateral rotators can be involved but as secondary muscles, not primary. There is so much to this discussion that I’m going to write a blog to describe it. Do you receive my blogs? While I will use your message as a start to the blog, I won’t use any names, etc., to protect your privacy.

I hope this will help to explain the hamstring issue. The key was when you said you noticed one leg is shorter, making me feel it’s not so much a hamstring problem as it is tightness in his psoas, iliacus, tensor fascia lata, and quadratus lumborum (which isn’t mentioned in the blog because it would have made the blog be too long). These muscles are overstretching his hamstrings and doing anything to them (stretching, massaging, etc.) could make them worse. You may want to consider getting my book Treat Yourself to Pain-Free Living which will show him how to treat each muscle, and a lot more. I believe he can resolve this problem, and that since he’s so young and loves sports, it’s important to take care of the muscles before they are seriously injured from the strain.